School District of Indian River County Bloodborne Pathogens

Transcription

1 School District of Indian River County Bloodborne Pathogens Overview of Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus

2 What this training will cover What are bloodborne pathogens and how are they transmitted Our exposure control plan to protect you from BBP How to recognize the workplace activities that could expose you to blood and other possibly infectious materials Methods that will prevent or reduce exposure including equipment and safe work practices and personal protective equipment General information about personal protective equipment Hepatitis B vaccine What to do if you are exposed to BBP

3 Bloodborne Pathogens (BBPs) BBPs are primarily Hepatitis B & C and HIV viruses present in blood, or in: O t h e r P o t e n t i a l l y I n f e c t i o u s M a t e r i a l s ( O P I M )

4 Bloodborne Pathogens - OPIM OPIM includes the following: Semen Vaginal secretions Pleural, cerebrospinal, pericardial, peritoneal, synovial, and amniotic body fluids Saliva with blood in dental procedures Any body fluids visibly contaminated with blood Undifferentiated body fluids Any unfixed tissue or organ (other than intact skin) from a human (living or dead) HIV, HCV or HBV-containing cultures (cell, tissue, or organ), culture medium, or other solutions Blood, organs, & tissues from animals infected with HIV, HCV HBV, or other BBPs

5 Transmission of BBPs Bloodborne pathogens can enter your body through: Contaminated instrument injuries A break in the skin (cut, lesion, etc.) Mucus membranes (eyes, nose, mouth) Other modes Photo by Sharonoa Gott in Creative Commons Photo by Jason Rogers in Creative Commons

6 Viral Hepatitis General Facts The virus attacks the liver causing inflammation, enlargement, and tenderness. Infections can be acute or chronic (immediate or long term). Liver damage can range from mild to fatal.

7 Hepatitis B Virus - HBV Can live for 7+ days in dried blood 100 times more contagious than HIV 46,000 new infections per year 1.25 million carriers 3,000 deaths/year No cure, but there is a preventative vaccine 30% - No signs or symptoms Photo by Graham Colm in Wikemedia Commons

8 Hepatitis B Transmission Unprotected sex with infected partner Sharing needles during injecting drug use From infected mother to child during birth Sharps/needle sticks

9 Flu-like symptoms Fatigue Abdominal pain Loss of appetite Nausea, vomiting Joint pain Jaundice Hepatitis B Symptoms

10 Hepatitis C Virus (HCV) The most common chronic bloodborne infection in the U.S. 12,000 deaths from HCV infections each year No vaccine currently available 80% - No signs or symptoms From CDC 2010 Hepatitis C Fact Sheet

11 Hepatitis C Symptoms Flu-like symptoms Jaundice Fatigue Dark urine Abdominal pain Loss of appetite Nausea Photo courtesy of Center for Disease Control (CDC) Photo courtesy Center of Disease Control (CDC)

12 Photo by Neil Hester in Creative Commons Hepatitis C Transmission Transmitted by: Injecting drugs Hemodialysis (long-term) From infected mother to child during birth Occupational exposure to blood mostly needlesticks Sexual or household exposures rare

13 Human Immunodeficiency Virus (HIV) Fragile survives only a few hours in dry environment Attacks the human immune system One million+ infected in U.S Cause of AIDS Vaccine not yet available

14 HIV infection = AIDS Many have no symptoms or mild flu-like symptoms Most infected with HIV eventually develop AIDS within years Available treatments do not yet cure

15 How is HIV transmitted? Sharing needles or syringes Sexual contact From HIV-infected women to their babies during pregnancy or delivery Breast-feeding Needlesticks (rare)

16 Statistics 1 out of every 75 people are infected or carriers of the pathogenic disease shown below. (Combined totals below of HIV, HBV & HCV) 1.10 million - U.S. Cumulative estimated number of AIDS diagnoses (2009) 1.4 million - U.S. residents living with chronic HBV (2007) million - U.S. residents living with chronic HCV (2007)

17 Exposure to BBPs at Work Some Definitions Occupational Exposure means reasonably anticipated skin, eye, mucous membrane, or piercing of the skin, contact with blood or OPIM that may result from the performance of an employee's duties. Graphic courtesy of WikiHow in Creative Commons Exposure Incident means an actual eye, mouth, other mucous membrane, non-intact skin or skin piercing contact with blood or OPIM while performing your work duties.

18 What are Sharps? Needles Syringes Lancets Auto Injectors Infusion Sets Connection needles/sets Scalpels Razors or other blades Broken glass or plastic containers Photo from FDA

19 How people can be exposed to BBPs at work Cleaning up broken containers containing blood or OPIM Restraining an infected combative patient, suspect, or inmate Cleaning surfaces contaminated with blood or OPIM Disposing of bloodborne pathogen hazardous waste Picking up discarded syringes or sharps in public places Providing emergency first-aid treatment Handling garbage bags with needles, broken glass or other sharps

20 School Exposure Activities 1. Administering first aid - Classroom especially during lockdown or an emergency evacuation - Science Labs (broken glass, sharps) - Sports injuries 2. Accident clean up and disposal of waste 3. Discipline and fight intervention

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22 Our BBP Exposure Control Plan The purpose is to eliminate or minimize your risk of exposure The Control Plan includes: Exposure determination Exposure controls Training and hazard communication Hepatitis B vaccine Post exposure evaluation & follow-up Recordkeeping

23 BBP Exposure Controls Universal precautions (or an equivalent system) Equipment and safe work practices Personal protective equipment Housekeeping Handling BBP waste materials

24 Exposure Controls Universal precautions A system of infection control that treats all human blood and OPIM as if it is infected with a bloodborne disease.

25 Handling Discarded Syringes Image by Massachusetts Dept. of Labor Standards Photo by Val Savarese in Creative Commons Avoid handling any needles, syringes or other sharps with your hands.

26 Contaminated Sharps Cleanup During clean-up of broken glassware/sharps that may be contaminated with blood or OPIM: Wear protective eyewear and mask if splashing is anticipated. Remove glass and other sharps materials using a brush and dust pan, forceps, hemostat, etc. Don t use your hands. Properly discard all materials into a sharps or puncture-resistant biohazardous waste container.

27 Needle/Sharps Disposal Sharps disposal containers must be: Closable Puncture-resistant Leak-proof Labeled or color-coded Upright, conveniently placed in area where sharps used

28 Other Safe work practices Remove gloves or other protective clothing before leaving work area. Always wash hands after each glove use and immediately after an exposure. A hand sanitizer may be used if soap and water is not immediately available. But, wash hands as soon as possible afterwards.

29 More Safe work practices Don t eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses in any work areas where there is the possibility of exposure to blood or OPIM. Photo courtesy of Lena Wang Dept. of Labor & Industries Don t place food or drink in refrigerators, freezers, shelves, cabinets, countertops or bench tops in any other work areas where blood or OPIM is located.

30 Cleaning Contaminated Surfaces All work surfaces and equipment contaminated with blood or OPIM must be cleaned up with an appropriate disinfectant as soon as possible. Photo courtesy of Center for Disease Control

31 Personal protective equipment (PPE) You must wear all required PPE. We provide you with all necessary PPE at no cost including one or more of the following: Gowns Gloves Lab coats Shoe covers Face shields or masks Eye protection Photo by Hospital in Creative Commons

32 Gloves must be worn whenever: - you have hand contact with blood, OPIM, mucous membranes or non-intact skin, - you handle or touch items or surfaces contaminated with blood or OPIM Photo courtesy U.S. Navy

33 Removing Gloves Safely Video clip demonstration Video clip

34 PPE Eye/Face Protection You must wear either a full face shield or combination of eye protection and mask if splashes, sprays or spatters of blood or OPIM to the face could occur.

35 PPE - Protective Clothing Appropriate protective clothing must be worn if splashes to skin or regular clothes could occur. They include one or more of the following: - Lab coat - Gown - Apron - Clinic jacket - Surgical cap or hood - Shoe cover or boot Gloves must be removed BEFORE removing any other PPE to avoid contamination.

36 Handling regulated waste containers Close immediately before removing or replacing. Place in second container if leaking possible or if outside contamination of primary container occurs. Photo by Brian Bald in Creative Commons

37 Hepatitis B Vaccine for exposed workers No cost to you 3 shots: 0, 1, & 6 months Effective for 95% of adults Photo courtesy U.S. Navy Post-vaccination testing for high risk workers If not vaccinated, post-exposure treatment with Immune globulin & vaccination shots is done If you decline, you must sign a Declination Form Vaccine available at later date if desired

38 If you have an exposure to blood or OPIM, immediately do the following: Photo from Wikipedia and creative commons Thoroughly clean the affected area. Wash needlesticks, cuts, and skin with soap and water. Flush splashes to the nose and mouth with water. Irrigate eyes with clean water, saline, or a sterile irrigant. Report exposure to your supervisor, or the person responsible for managing exposures.

39 Post-Exposure Evaluation We will provide the following: A post-exposure medical evaluation and follow-up to for you: - at no cost - confidential - to include testing for HBV, HCV, HIV - preventive treatment when indicated With their consent, we will test blood of source person if their HBV/HCV/HIV status is unknown, and provide the results to you.

40 Biohazard labels and signs: Containers with blood or OPIM must have the biohazard symbol Labels attached securely to any containers or items containing blood/opim Red bags/containers may substitute for labels Signs are posted at entrance to specified work areas

41 Quiz Question 1 Which of the following is considered OPIM? a) Blood b) Saliva c) Body fluids containing blood d) All of the above

42 Quiz Question 2 Which of the following infections can be prevented with a vaccine? a) HIV b) Hepatitis A c)hepatitis B d) Hepatitis C

43 Quiz Question 3 What are Universal Precautions? a) What everybody does with bloodborne pathogens b) Protective methods used throughout the world c) Treating all blood and OPIM as if it is contaminated with BBP d) Methods used to treat someone with Hepatitis C

44 Quiz Question 4 When does a face shield have to be worn? a) When handling blood sample vials b) When there is a risk of splash to the eyes c) In a medical laboratory setting d) Around patients known to be HIV positive

45 Quiz Question 5 When is a post-exposure medical evaluation required? a) Whenever you have a needlestick b) After having the hepatitis B vaccination c) Whenever you have to pick up contaminated syringes d) After you handle blood-contaminated laundry

46 Quiz Question 6 As long as you wear gloves, you don t have to wash your hands a) True b) False

47 Quiz Question 7 All contaminated material must be sealed in a red bio-hazard bag for proper disposal a) True b) False

48 Quiz Question 8 Disposable gloves can be reused as long as they are washed a) True b) False

49 Quiz Question 9 You should always remove your gloves before removing any other PPE a) True b) False

50 Quiz Question 10 Hepatitis B virus can live for seven days or more in dried blood a) True b) False

51 Any Questions?